Ageing is a gradual and continuous process of natural change that begins in early adulthood. Most veterans of NFPC retire when they are middle-aged, which is generally considered the period between 40-60. During early middle age, many bodily functions begin to gradually decline which tend to increase as one enters old age. Life expectancy of Indians has doubled from just about 35 in 1950 to 70 in 2022. This is largely due to improvements in medical science, better access to clean water and food that is more plentiful and nutritious. Medical discoveries such as antibiotics and vaccines have drastically reduced the prevalence of once feared diseases such as smallpox, tuberculosis, plague, typhoid, hepatitis, polio and rabies. People are also more aware of the benefits of exercise and wise lifestyle decisions. At the same time, the lifestyle of many Indians – especially those living in urban centres such as Pune – has become much more sedentary, which has created its own set of problems such as obesity, diabetes, hypertension and cardiovascular diseases. To ensure that veterans control some of the undesired effects of ageing, some best practices are outlined below. The goals of such ‘healthy ageing’ are to maintain good physical and mental health, avoid disorders and remain active and independent till a ripe old age. Towards this end, the three basic principles which need to be followed are to follow a nutritious diet, exercise regularly and stay mentally active.

Factors of Life Expectancy

• Heredity influences whether a person will develop a disorder and is dependent on our genes.
• Lifestyle. Avoiding smoking, consuming alcohol in moderation, maintaining a healthy weight and diet, and exercising help people function well and avoid disorders.
• Exposure to toxins in the environment – which are increasing alarmingly in most of our cities – can shorten life expectancy, even for those who are otherwise healthy.
• Health care has improved tremendously and timely medical check-ups and treatment can make a huge difference in increasing our life expectancy

Effects of Ageing

Bones and Muscles. Often, the first signs of ageing involve the musculoskeletal system. The eyes, followed by the ears, begin to change early in mid-life. Bones tend to become less dense and can lead to osteoporosis. Similarly, damage to cartilage due to lifelong use of joints often leads to osteoarthritis. Ageing also reduces muscle mass and strength. By around 75, the percentage of body fat typically doubles compared with what it was during young adulthood.

Eyes. As people age, the eye lens stiffens, making focusing on close objects harder. It also becomes denser, making seeing in dim light harder. The pupil reacts more slowly to changes in light. The lens yellows, changing the way colours are perceived. The number of optic nerve cells decrease, impairing depth perception. The eyes produce less fluid, making them feel dry. These changes can lead to many conditions such as loss of near vision (presbyopia), changes in colour perception and contrast, and presence of floaters i.e. tiny black specks moving across their field of vision.

Ears. Age-associated hearing loss (Presbycusis) is the most common disorder due to ageing requiring the use of hearing aids.

Mouth and Nose. With ageing, taste and smell start to gradually diminish. Many foods tend to taste either bitter or bland.

Skin. The skin tends to become thinner, less elastic, drier, and finely wrinkled. This is due to the aging body producing less collagen and elastin. The subcutaneous fat layer, which preserves heat, thins.

Brain and Nervous System. The number of nerve cells in the brain typically decreases.

Heart and Blood Vessels. The heart and blood vessels become stiffer, which leads to high blood pressure. The heart also fills with blood more slowly.

Respiratory System. The muscles used in breathing, such as the diaphragm, tend to weaken. The number of air sacs (alveoli) and capillaries in the lungs decrease, resulting in less oxygen being absorbed from the air. The lungs’ ability to fight infection also reduces.

Digestive System. The digestive system is less affected by ageing. However, disorders such as constipation can occur more frequently. Liver function also declines.

Kidneys and Urinary Tract. Controlling urination becomes more difficult and incontinence is fairly common amongst elders. The maximum volume of urine that the bladder can hold decreases, causing the need to urinate more often.

Endocrine System. The growth hormone levels decrease, leading to decreased muscle mass. Insulin, which controls the blood sugar level is less effective, which may result in diabetes.

Blood & Immune System. The amount of active bone marrow, where blood cells are produced, decreases. The cells of the immune system act more slowly which can result in easier infections, which take longer to cure. Anaemia is a condition when your blood produces fewer healthy red blood cells. Consequently, the body does not get enough oxygen-rich blood which can make you feel tired or weak.

Healthy eating

Making smart food choices can help protect you from certain health problems as you age and may even help improve brain function. Today, there are a multitude of diets out there, all of which promote themselves as the ultimate in nutrition and the key to good health. Many of these require subscribing as a paid member and on the whole, their efficacy is not proven across the board for all categories of individuals. Some guidelines of what constitutes a ‘healthy diet’ are listed below, with the disclaimer that these are based on the large amount of research carried out over the years by nutrition experts and not a recommendation in any way.

Eat as much natural and fresh produce as possible, instead of processed and ‘junk’ food. This includes fresh fruits and vegetables, whole (not polished) grains like millets, whole-grain bread, and brown rice, whole cuts of meat, poultry and fish, eggs, unsalted nuts, green leafy vegetables and food rich in fibre. Avoid fried foods, especially those using trans fats (vanaspati) and foods rich in sodium. Choose broiled, grilled, or boiled options instead. Take skimmed milk, milk products; or nondairy soy or almond milk, preferably fortified with Vitamin D and calcium to help keep your bones strong as you age. Drink fluids throughout the day, even if you do not feel particularly thirsty, but avoid sugar-sweetened drinks including the so-called ‘healthy’ fruit juices.

Weight

Both the quality and quantity of your food intake, in terms of calories, have a direct impact on your weight. Over time, if you eat and drink more calories from food or beverages than your body uses from physical activity and daily living, your body may store the extra calories leading to weight gain. Many people eat more than they need, especially when eating out or getting takeout. Being overweight may increase your risk for Type 2 diabetes, heart disease, high blood pressure, high blood cholesterol, kidney disease, fatty liver disease, certain types of cancer, Alzheimer’s disease and other dementias. Two measures can help you determine whether you are at a healthy weight. Body mass index (BMI) is a measure based on your weight in relation to your height. You can use an online tool to calculate your BMI. Older adults should ideally have a BMI between 25 and 27. However, some older adults may have a BMI in the healthy range but still have too much body fat which can be assessed by measuring your waist size. Women with a waist size of more than 35 inches and men with a waist size of more than 40 inches may be more likely to develop health problems. Hence you need to control your portion sizes as well as the number of times you eat during the day, especially snacking when watching TV. At the same time, avoid skipping meals, as doing so may make you hungrier later leading to stuffing yourself.

On the other hand, being underweight can also be a health concern for older adults. It could mean that you have an increased risk for weakness and bone loss, are not eating enough calories to maintain your weight, don’t have access to enough food or foods that meet your nutrient needs, or have an illness or medical condition.

Exercise

Physical activity and regular exercise are essential towards healthy ageing. Exercise improves the cardiovascular system, reduces the chances of developing lifestyle diseases and also improves mental health. Such exercise could include a regular game of golf – popular amongst most seniors, which besides the physical activity also is a wonderful means of maintaining social interaction with friends. For those not inclined towards golf, other exercises could include walking or swimming, both of which should be undertaken in a manner that does not place undue stress on the heart. In addition to aerobic (or cardio) exercises, try and regularly do exercises to strengthen muscles (generally in a gym), activities to improve balance, activities to increase flexibility and activities that combine more than one type of physical activity. Exercise – combined with a good diet – can also help in maintaining a healthy weight. Adults with obesity have an increased risk of death, disability, and many diseases such as Type 2 diabetes and hypertension. Exercise can also help older adults maintain muscle mass. Keep in mind that some physical activity is better than none. Aim to keep moving as often as you can. Try and exercise regularly at least 3 days a week and choose activities you enjoy. Start with small goals and try to slowly increase your pace, the length of time you are active, and how many days of the week you are active, to the extent you are comfortable with. Also, make sure you remain hydrated during exercise.

Sleep

Getting a good night’s sleep is key to helping veterans stay healthy and alert. Not getting enough quality sleep can make a person irritable, depressed, forgetful, and more likely to have falls or other accidents. Studies have also shown that insufficient sleep could result in neurological disorders such as dementia and Alzeheimer’s disease in later years, as well as worsen depression symptoms. On the other hand, getting good sleep is associated with lower rates of insulin resistance, heart disease, and obesity. Towards ensuring a good night’s sleep, some of the things which one can do are :-

• Try to fall asleep and get up at the same time each day.
• Avoid napping late in the day, as this may keep you awake at night.
• Exercise can help you sleep better, too, if it isn’t too close to bedtime.
• Meditation, can also improve sleep quality.

Lifestyle Habits

Smoking. Research has confirmed for a long time now that smoking is harmful to health and a leading cause of lung cancer. Even if you have been a habitual smoker, cutting down on your daily intake or, better still, quitting altogether will certainly have a beneficial effect on your health including:-

• Lower your risk of cancer, heart attack, stroke, and lung disease.
• Improve your blood circulation.
• Improve your sense of taste and smell.
• Increase your ability to exercise.

Alcohol. While the adverse effect of alcohol cannot be compared with smoking, it is the amount of consumption which matters. Moderate drinking is a socially acceptable norm, but one needs to remember the limits, beyond which one’s physical and mental faculties become adversely affected. Older adults should avoid or limit alcohol consumption as they are more susceptible to the ill effects. Other than the adverse effects on the body, consuming excess alcohol can impair the senses and slow reactions and, hence, one should never drink and drive.

Health Checkups

Going to the doctor for regular health screenings is essential for healthy ageing. Such check-ups help doctors catch chronic diseases early and can help patients reduce risk factors for disease, such as high blood pressure and cholesterol levels, as well as improve the quality of life and feelings of wellness. Medical science in addition to discovering cures for previously fatal diseases has also developed a range of medical tests, including pathological tests (mostly of blood and urine) and radiological imaging methods that help uncover signs of age-related disease. This enables doctors to identify harmful changes in your body even if they occur years before you start to experience any symptoms of the disease itself. Hence, regular visits to doctors for physical examinations and lab screenings can uncover diseases and conditions you may not yet be aware of, such as diabetes, cancer, and cardiovascular disease and start treatment months or years earlier than would have been possible otherwise. If you only seek medical attention when you experience symptoms, you may lose the chance of detecting a disease in its earliest stages, when it would be most treatable.

Mental Health

Mental health, or mental wellness, is essential to your overall health and quality of life. It affects how we think, feel, act, make choices, and relate to others. Managing social interactions with family, relatives, friends and coursemates could mitigate feelings of social isolation, loneliness, stress and depression as one gets older. Adverse effects of mental health could impact memory and faster cognitive decline. On the other hand, being socially active can have several benefits including more physical activity, the feeling of well-being, and improved mood.

Stress

Stress is a natural part of life and comes in many forms. Sometimes stress arises from difficult events or circumstances. Constant stress can change the brain, affect memory, decision making and increase the risk of developing Alzheimer’s or related neurological disorders. Older adults are at particular risk for stress and stress-related problems. Finding ways to lower stress and increase emotional stability may support healthy ageing. Long-term stress also may contribute to or worsen a range of health problems, including digestive disorders, headaches, and sleep disorders. Stress can be, however, managed through meditation techniques, physical activity, social interaction, keeping a journal and reaching out to friends and family when faced with difficulties.

Depression

Although depression is common in older adults, it can be difficult to recognize. Furthermore, sadness may not be the main symptom of depression for them. Instead, they might feel numb or uninterested in activities and may not be as willing to talk about their feelings. Depression can also affect physical health, including the increasing risk of heart disease and metabolic disorders and dementia. Depression can, however, be treated. Hence seniors who experience signs such as deep sadness or numbness, lack of sleep and loss of appetite are also common symptoms of depression, should consult a mental health professional.

Cognitive health

Cognition — the ability to clearly think, learn, and remember — often changes as we age. Although some people develop Alzheimer’s or other types of dementia, many older adults experience more modest changes in memory and thinking. Healthy eating, staying active, and learning new skills may help keep older adults cognitively healthy. There is also some evidence that exercising your brain by learning a new skill can improve memory function. Such skills could include computer skills such as photo editing and web design, learning a new game, instrument, craft, or other activity.

Leisure activities and hobbies

People who participate in hobbies and social and leisure activities may be at lower risk for some mental health problems. These could include listening to music, going to the theatre or dance performances, creative writing, and other activities in which one may have an interest. Taking care of a pet can also improve your health. There could be any number of similar activities that one could try out such as going to a sporting event, trying a new restaurant, visiting a museum, learning how to cook or play a musical instrument, or taking up social work as a volunteer.